Provider Demographics
NPI:1114890076
Name:HOPE HARBOR BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:HOPE HARBOR BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:
Authorized Official - First Name:ALISSA FODOR
Authorized Official - Middle Name:
Authorized Official - Last Name:FODOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-959-3994
Mailing Address - Street 1:100 HIGHLAND AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-2702
Mailing Address - Country:US
Mailing Address - Phone:781-244-0115
Mailing Address - Fax:781-989-8149
Practice Address - Street 1:100 HIGHLAND AVE STE 204
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2702
Practice Address - Country:US
Practice Address - Phone:781-244-0115
Practice Address - Fax:781-989-8149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-26
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder